7. Secure cannula in effective position, and attach IV

extension tubing to underwater drainage system with

suction pressure of 10 cm H2O. The smaller cannula

will require higher suction pressures unless the air

accumulates slowly. Because air loculates within the

mediastinum and the side holes occlude easily, small

catheters are rarely effective for anything other than

acute relief of tension. Remove cannula as soon as

possible.

References

1. Dull KE, Fleisher GR. Pigtail catheters versus large-bore chest

tubes for pneumothoraces in children treated in the emergency

department. Pediatr Emerg Care. 2002;18:265.

2. Lawless S, Orr R, Killian A, et al. New pigtail catheter for pleural

drainage in pediatric patients. Crit Care Med. 1989;17:173.

3. Wood B, Dubik M. A new device for pleural drainage in newborn

infants. Pediatrics. 1995;96:955.

4. Rothberg AD, Marks KH, Maisels MJ. Understanding the Pleurevac.

Pediatrics. 1981;67:482.

5. Gonzalez F, Harris T, Black P, et al. Decreased gas flow through

pneumothoraces in neonates receiving high-frequency jet versus

conventional ventilation. J Pediatr. 1987;110:464.

6. MacDonald MG. Thoracostomy in the neonate: a blunt discussion. NeoReviews. 2004;5:c301.

7. Chan L. Medial pneumothorax: a radiographic sign that should

not be overlooked on the supine view. Am J Emerg Med. 1999;

17:431.

8. Dennis J, Eigen H, Ballantine T, et al. The relationship between

peak inspiratory pressure and positive end expiratory pressure on

the volume of air lost through a bronchopleural fistula. J Pediatr

Surg. 1980;15:971.

9. Zidulka A. Position may reduce or stop pneumothorax formation

in dogs receiving mechanical ventilation. Clin Invest Med. 1987;

10:290.

10. Stevens TP, Harrington EW, Blennow M, et al. Early surfactant

administration with brief ventilation vs. selective surfactant and

continued mechanical ventilation for preterm infants with or at

risk for respiratory distress syndrome. Cochrane Database Syst

Rev. 2007;17:CD003063.

11. Ryan CA, Barrington KJ, Phillips HJ, et al. Contralateral pneumothoraces in the newborn: incidence and predisposing factors.

Pediatrics. 1987;79:417.

12. Kuhns LR, Bednarek FJ, Wyman ML. Diagnosis of pneumothorax or pneumomediastinum in the neonate by transillumination.

Pediatrics. 1975;56:355.

13. Wyman ML, Kuhns LR. Accuracy of transillumination in the recognition of pneumothorax and pneumomediastinum in the neonate. Clin Pediatr. 1977;16:323.

14. Albelda SM, Gefter WB, Kelley MA, et al. Ventilator-induced

subpleural air cysts: clinical, radiographic, and pathologic significance. Am Rev Respir Dis. 1983;127:360.

15. Allen RW, Jung AL, Lester PD. Effectiveness of chest tube

evacuation of pneumothorax in neonates. J Pediatr. 1981;99:

629.

16. Batton DG, Hellmann J, Nardis EE. Effect of pneumothoraxinduced systemic blood pressure alterations on the cerebral circulation in newborn dogs. Pediatrics. 1984;74:350.

17. Cartlidge PH, Fox PE, Rutter N. The scars of newborn intensive

care. Early Hum Dev. 1990;21:1.

18. Bhatia J, Mathew OP. Resolution of pneumothorax in neonates.

Crit Care Med. 1985;13:417.

19. Merenstein GB, Dougherty K, Lewis A. Early detection of pneumothorax by oscilloscope monitor in the newborn infant. J Pediatr.

1972;80:98.

20. Noack G, Freyschuss V. The early detection of pneumothorax

with transthoracic impedance in newborn infants. Acta Paediatr

Scand. 1977;66:677.

21. Grim P 3rd, Keenan WJ. Two uncommon radiographic signs of

an anterior neonatal pneumothorax. Correlated with clinical finding. Clin Pediatr. 1986;25:440.

22. Genc A, Ozcan C, Erdener A, et al. Management of pneumothorax in children. J Cardiovasc Surg. 1998;39:849.

23. Mehrabani D, Kopelman AE. Chest tube insertion: a simplified

technique. Pediatrics. 1989;83:784.

24. Mauer JR, Friedman PJ, Wing VW. Thoracostomy tube in an

interlobar fissure: radiologic recognition of a potential problem.

AJR. 1981;139:1155.

25. Strife JL, Smith P, Dunbar JS, et al. Chest tube perforation of the

lung in premature infants: radiographic recognition. AJR. 1983;

141:73.